Nausea

About your health

Please answer the following questions to help us confirm that you'll follow the guidelines for this medicine.

Women only: Are you pregnant or is there a possibility you may be pregnant or start breastfeeding while taking this medicaiton?

Yes

Are you taking any medications?

Yes

Do you suffer from any allergies?
If you do, kindly explain them below

Yes

Are you taking any of the following?

- Sedatives or tranquilisers, used to help you sleep (such as diazepam and temazepam)

- Antihypertensive medicines, used to treat high blood pressure (such as atenolol, propranolol or clonidine)

- Anticholinergic medicines, used for conditions such as depression (such as amitriptyline and imipramine)

- Anticonvulsant medicines used to prevent or treat fits such as carbamazepine and lamotrigine)

- Lithium (used to treat mania and depression)

- Desferrioxamine (used to treat high levels of iron in your body).

Yes

Acknowlegdements

Do you agree to seek immediate medical attention if you experience any of the following symptoms:

- Sudden, severe abdominal (tummy) pain.

- Severe chest pain.

- Blood in your vomit or what looks like coffee granules.

- A stiff neck and high temperature (fever).

- A sudden, severe headache that's unlike any headache you've had before.

Yes

Do you understand that it is very important to prevent dehydration by taking small sips of water frequently if you are unable to drink fluids normally?

Yes

Can we share this information with your General practitioner?

Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.

Yes

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